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Biomedical subjects

M Antoine

Publications and source records attributed to M Antoine.

At least 109 records · Page 6Linked to original sources
PubMed1996

Long-term follow-up of heart transplant patients.

The present study was designated to assess long term functional capacity, blood pressure and renal function at 12 and 60 months after heart transplantation. The data of sixty heart transplant recipients were retrospectively reviewed. At rest, radionuclide ejection fraction and cardiac index measured by thermodilution were within normal range, demonstrating normal left systolic function. In all patients, exercise tests were performed sitting on a bicycle. Peak oxygen uptake decreased from 23 +/- 6 to 19 +/- 6 ml/kg/min (mean +/- S.D.) respectively at 12 and 60 months after surgery (p < 0.01), which represent a 17% diminution in functional capacity. This decrease is nevertheless only related with a 10 kg increase in total body weight (69 +/- 9; 79 +/- 12 kg; p < 0.001) and thus absolute peak oxygen uptake remained unchanged. Blood pressure rised significantly since the first month after transplantation. Sixty-seven percent of recipients had systemic hypertension at 60 months, despite medical therapy. A decline in renal function was observed in all patients, beginning after the first year of transplantation.

Adolescent↗
PubMed1996

[Mulleroblastoma of the uterus. Role of chemotherapy. A case report].

A case of mulleroblastoma, a malignant mixed Muller tumour, of the uterine body was observed in a 51-year-old patient. This is a rare but severe tumour. Clinically, there is a long latence period and early haematogenous metastases leading to failure of radiotherapy and surgical treatment. Recent data, particularly from immunohistochemistry studies, would suggest that the epithelial component plays a major role in pathogenesis. A therapeutic approach combining surgery, aggressive chemotherapy and radiotherapy allows improved prognosis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1996

Determinants of right ventricular failure after heart transplantation.

Predictive factors of right ventricular failure after heart transplantation are not well identified. Clinical and hemodynamic data from 20 patients who developed right heart failure were compared to those of 20 matched patients who did not experience this complication after cardiac transplantation. Preoperative systemic and pulmonary hemodynamics were comparable in the two groups. Patients with posttransplant right ventricular failure had longer waiting time (27 +/- 6 vs 16 +/- 3 weeks, mean +/- SE, P < 0.05), no regression of pulmonary hypertension (0 +/- 0.1 vs 2.3 +/- 0.3 Wood units reduction in pulmonary vascular resistance after transplantation, P < 0.01), and had been ventilated with higher levels of positive end-expiratory pressure (5 +/- 1 vs 1.5 +/- 0.5 cm H2O, P < 0.05). One-month postoperative evolution (mortality, hospital stay, radionuclide ejection fractions) was similar in the two groups. These results suggest that a lesser reversibility of pulmonary hypertension (possibly due to a longer evolution of the cardiac disease, as indicated by the longer waiting time) is the main determinant of right ventricular failure after heart transplantation.

Heart Transplantation↗
PubMed1995

Plasma endothelin and early coronary endothelial dysfunction in recipients of a cardiac transplant.

Serotonin constricts coronary arteries with endothelial dysfunction, possibly through reduced endothelial release of nitric oxide or enhanced production of constricting factors such as endothelin. Because the plasma levels of this peptide are increased in the early months after cardiac transplantation, we assessed whether a coronary hypersensitivity to the vasoconstrictor effect of serotonin is associated with high plasma endothelin levels. One to 3 months after cardiac transplantation, serotonin (1, 10, or 20 micrograms/min for 2.5 min each) was infused into the coronary circulation in 32 patients. Changes in coronary diameters were determined by quantitative angiography. A > or = 40% reduction in coronary diameter for a dose of serotonin < or = 10 micrograms/min was observed in group A (n = 14) whereas in group B (n = 18), this diameter reduction was never reached even for a 20 micrograms/min infusion of serotonin. Plasma endothelin levels were significantly higher (p < 0.01) in the coronary ostium and coronary sinus in group A, at 23.4 +/- 1.3 pg/ml and 24.9 +/- 0.9 pg/ml versus 12.6 +/- 0.9 pg/ml and 13.8 +/- 1.1 pg/ml, respectively, in group B. These endothelin levels did not significantly change after intracoronary infusion of serotonin. A significant correlation was found between plasma endothelin levels in the coronary ostium and peak coronary constriction (percentage diameter reduction) in both groups (r = 0.77 for group A and r = 0.92 for group B). Thus, early after cardiac transplantation, serotonin-induced coronary constriction is a common finding, and the severity of this abnormality seems to be influenced by plasma endothelin levels.

Blood Pressure↗
PubMed1995

Persistent hyperinflation after heart-lung transplantation for cystic fibrosis.

We have measured static lung volumes after heart-lung transplantation (HLT) in seven patients with cystic fibrosis (CF) (Group 1), three patients with chronic hyperinflation due to diseases other than CF (Group 2), and six patients with primary pulmonary hypertension (PPH) (Group 3). Total lung capacity was within normal limits at 1 yr after surgery in all patients. Similarly, FRC was within the normal range in Groups 2 and 3. On the other hand, patients with CF showed a persistent increase in FRC; at 1 yr after HLT, FRC averaged 4.13 +/- 0.52 L compared with a predicted value of 3.20 +/- 0.23 L (p < 0.01). The postoperative static pressure-volume curve of the lung in the patients with CF was superimposed on the predicted one, suggesting that the increased FRC originated in the chest wall. Additional studies with computerized tomographic scans demonstrated that the rib cage anteroposterior diameter at FRC averaged 12.1 +/- 1.6 cm in patients with CF, 9.5 +/- 1.2 cm in patients with PPH, and 9.4 +/- 0.7 cm in a group of healthy subjects matched with the patients with CF (p < 0.01). We conclude that after HLT, patients with CF show persistent hyperinflation due to rib cage expansion along the anteroposterior dimension. This shape change may represent a structural adaptation that occurs in response to chronic pulmonary hyperinflation acquired during rib cage growth.

Adolescent↗
PubMed1995

Site-directed bronchoalveolar lavage and transbronchial biopsy in HIV-infected patients with pneumonia.

We have assessed the diagnostic value of site-directed bronchoalveolar lavage (BAL) and combined transbronchial biopsy (TBB) in 29 HIV-infected patients with localized pneumonia, in whom a previous BAL was nondiagnostic and in whom improvement did not occur with empiric antibiotic therapy. All patients but three had a CD4 cell count < 100/microliters. A definite diagnosis could be reached in 26 of 29 (90%) individuals, including 24 pathogens. Neither the radiologic pattern nor the type of Pneumocystis carinii (PC) prophylaxis could predict the positivity of either one of these two diagnostic procedures. Site-directed BAL alone allowed a diagnosis in infection in eight (28%) cases. TBB alone led to diagnosis in eight (28%) cases, including three PC and two toxoplasma gondii, undiagnosed by the site-directed BAL. Both techniques were positive and in agreement in 10 (34%) cases. The majority of the diagnosis led to a specific treatment. Therefore, the patients' survival was positively altered by the procedure. In conclusion, the performance of site-directed BAL and combined TBB markedly optimizes the diagnostic yield of each of these procedures performed separately in HIV-infected patients with localized pneumonia.

Adult↗
PubMed1995

Inert gas single-breath washout after heart-lung transplantation.

We prospectively studied the distribution of ventilation in 22 heart-lung transplant (HLT) recipients. At entry into study, the patients had undergone surgery an average of 6.7 mo earlier, and were followed for a mean period of 16 mo. Vital-capacity (VC) single-breath washouts as well as single-breath washouts using a 1-L inspiration from FRC were performed on a total of 395 occasions. The inhaled gas mixture consisted of 5% He, 5% SF6, and 90% O2, and the expired N2, He, and SF6 concentrations were analyzed. Six patients showed normal standard pulmonary-function tests and indexes of ventilation distribution throughout the study. Five patients gradually developed an irreversible airflow obstruction, presumably due to obliterative bronchiolitis (OB). They showed increases in the slopes of the N2, SF6, and He alveolar plateaus (SN2, SSF6, S(He)), but because S(He) increased more than SSF6, the slope difference (SSF6-S(He)) invariably decreased and became negative in four of five patients. Thirteen patients developed 16 episodes of reversible airflow obstruction as a result of acute infection or rejection of the lung allograft. The alterations in ventilation distribution were qualitatively similar to those seen in patients with OB. We conclude that: (1) ventilation distribution in the lung periphery is normal in HLT recipients with adequate allograft function; (2) the airflow obstruction elicited by OB and acute episodes of lung infection or rejection is accompanied by increases in SN2, SSF6, and S(He) and decreases in SSF6-(He)).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Ontogeny of GnRH systems.

In all vertebrate species studied, the main central population of GnRH neurones, which produces the final messages regulating reproduction, originates outside the brain. Early during fetal life, they appear in the olfactory placode epithelium and then migrate toward the base of the telencephalon in close association with the nervus terminalis, penetrate the brain within the nervus terminalis roots, reach their final locations and eventually grow axons toward their targets. Only part of this process is documented in ruminants. In the sheep fetus, the olfactory placode develops between day 22 and day 26 of gestation, but the first GnRH-immunoreactive neurones have been detected only at day 35, associated with the extracerebral part of the nervus terminalis. During the next 30-40 days, the GnRH neuronal systems progressively invade the brain. In both sexes, most of the development, in terms of distribution and morphology of the neurones, appears to be completed by the middle of gestation (term being on day 145). On day 85 GnRH-immunoreactive neuronal systems of male and female fetuses have also been reported to be very similar to GnRH neuronal systems of adult females. Attention should now be focused on the earliest developmental steps.

Animals↗
PubMed1995

[Contribution of bronchoalveolar lavage in immunosuppressed patients].

The safety of bronchoalveolar lavage has been greatly contributed to its widespread use in immunodepressed patients. This examination has changed the diagnostic approach to many lung diseases and often eliminates the need to open the thorax to make a lung biopsy. Bronchoalveolar lavage can be used to screen for a large number of diseases, particularly those due to infectious agents. In non-infectious diseases, the contribution of bronchoalveolar lavage is more limited. The impact of molecular biology techniques remains to be established.

Bronchoalveolar Lavage Fluid↗
PubMed1995

[Solid breast nodules: reliability of ultrasonographic and cytological studies].

The authors evaluated the usefulness of US study and US guided fine-needle aspiration cytology (FNAC) in 144 solid breast lesions. US studies was performed with a 10-MHz transducer. Homogenous hypoechogenicity, elongation along the general orientation of the breast tissue plane, regular margins, and intensification of posterior echoes were considered as benign signs. US guided FNAC was performed when lesions were depicted at US. The smears were performed immediately by the cytologist who was present during the procedure. US signs and FNAC diagnoses were compared with surgical/core biopsy diagnoses or negative imaging follow-up. The sensitivity of US was 93%, specificity 75%, accuracy 81%. Among 41 malignant lesions the cytologic findings were malignant (n = 26) or suspicious (n = 7) with 1 false positive and 2 false negative. Inadequate samplings were less frequent last year study (13.5%). The sensitivity of cytologic diagnosis was 94%, specificity 85%, and accuracy 88%. US study and FNAC could be helpful in evaluating solid breast lesions. A better accuracy may be obtained if FNAC is associated with core biopsy.

Adult↗
PubMed1995

[Disseminated histoplasmosis in an HIV seropositive patient].

The authors report a case of disseminated pulmonary histoplasmosis in an HIV positive patient who had travelled in countries where the disease was endemic. The principle clinical characteristics of the disease are reviewed including the radiology and the methods of treatment particularly in the forms occurring in this context. Finally the authors underline the difficulty in the differential diagnosis with tuberculosis.

Adult↗
PubMed1995

[Pulmonary artery hypertension due to tumor micro-embolism].

We report the case of a 37 years old woman with a past history of a chondrosarcoma who was admitted to hospital for acute pulmonary hypertension which proved rapidly fatal; autopsy confirmed that the etiology was tumour microemboli rising from a single cardiac metastases from her chondrosarcoma. The originality of this case report lies in the origin of the microemboli and the way in which they presented as a recurrence of the cancer.

Adult↗
PubMed1994

The gene encoding glyoxalase I from Pseudomonas putida: cloning, overexpression, and sequence comparisons with human glyoxalase I.

The gene encoding glyoxalase I (GlxI) from Pseudomonas putida has been cloned into the high-expression plasmid pBTacI. In the presence of IPTG, JM109 cells transformed with this vector give expression levels of GlxI 4000-fold higher than wild-type Escherichia coli. Contrary to a previous report, the nucleotide sequence of the gene encodes a 173-amino-acid polypeptide. Edman analysis indicates that the predicted N-terminal methionine is lost post-translationally to yield a 19407-Da protein. Mass spectrometry of the intact protein, and of the peptides generated from treatment with CNBr, does not indicate any additional post-translational modifications of the enzyme. Contrary to previous conclusions, there are no major regions of dissimilarity between the human and bacterial enzymes.

Amino Acid Sequence↗
PubMed1994

Human papillomavirus type 16 associated with multifocal transitional cell carcinomas of the bladder in two transplanted patients.

This report describes two cases of rapidly progressive, multifocal transitional cell carcinomas of the bladder that developed in two patients after renal and cardiac transplantation, respectively. In both cases human papillomavirus (HPV) type 16 DNA was detected using the polymerase chain reaction DNA amplification method. To our knowledge, this HPV type has not been previously described in multifocal bladder transitional cell carcinoma in transplanted patients. Our findings suggest that HPV may play a major role in the development of rapidly progressive, multifocal transitional cell carcinoma in immunosuppressed patients.

Base Sequence↗